The present invention relates to devices, methods, systems and kits that enable selective dissection of lung tissue to remove diseased tissue from healthy tissue without damaging blood vessels or airways. The invention and methods enable minimally invasive lung surgery procedures by providing a device and method to perform automated dissection that discriminates against traumatizing critical lung tissue.
Relatively few thoracic procedures are performed using minimally invasive or video assisted thoracic surgical techniques (VATS) even though they are well known to provide benefit to the patient by minimizing trauma and speeding recovery compared to open chest procedures. This is due, at least in part, to the fact that there are only a few available instruments designed specifically to enable thoracic procedures in this way.
Current clinical practice to remove lungs, lung lobes or lung tissue segments involve opening the chest by cutting the sternum or by spreading the ribs. Many times ribs are broken and often segments are surgically removed during these procedures. The orthopedic trauma alone presents considerable pain and it can complicate the recovery process with patients. Thoracic pain of this magnitude complicates the task of recovering a patient from general anesthesia since the body acclimates to forced ventilation and the pain can interrupt natural chest rhythm. Patients benefit dramatically from procedures that are performed through small incisions or ports in the chest without causing this orthopedic trauma.
The bulk of the procedural time and effort required to surgically remove lung tissue entails dissection of tissue away from critical structures such as arteries, veins and airways so they can be closed off properly and then transected. Currently, surgeons use standard forceps, scissors, and scalpel instruments to tease tissue away from these structures. This work is dangerous because the vasculature is coupled directly to the heart and a mistakenly lacerated vessel results in large, and sometimes, uncontrollable hemorrhage.
Dissection using manual instruments is slow because the physician must constantly anticipate stressing a critical structure and possibly rupturing the tissue. A typical technique involves plunging a scissor type instrument forward and then spreading it to tear tissue apart. It is slow, dangerous and requires good visualization and surgical skill to avoid complications.
Hence, there is a need for a device that is automated and safer and allows the physician to concentrate less on each stroke of a manual instrument and allows for a more minimally invasive approach.